Puberty blockers: NHS to set up independent review group

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A new independent review group will assess the prescription of puberty blockers for under-16s, NHS England has announced.

Puberty blockers are prescribed to some young people who are experiencing gender dysphoria - a "mismatch" between their biological sex and gender identity.

The announcement follows a ruling from the Family Division of the High Court in March, which said parents can consent to the treatment on behalf of their child.

But the judge added it may be that "additional safeguards" should be built into decision-making.

The case was brought after three high court judges had previously ruled that children under 16 were unlikely to be able to give informed consent for the treatment.

That ruling, in December, was from a case brought against the Tavistock and Portman NHS Trust which provides England's only NHS specialist gender clinic for children.

NHS England said its new processes were being introduced on an "interim basis" while it awaits the outcome of a review into gender identity services.

It said it had "carefully reviewed" the parental consent judgement from March along with "significant concerns" raised by a recent Care Quality Commission report about the clinic and a puberty blockers evidence review by the National Institute for Health and Care Excellence.

image captionThe Tavistock and Portman NHS Trust provides England's only NHS specialist gender clinic for children

The health body said that while parental consent had not been "historically" relied on it may be for existing patients who are already being prescribed puberty blockers.

In such cases there would need to be "full agreement" between the child, parent(s) and clinical team as well as support from the new review group.

It added that, should the review group have doubts about whether the decision-making process was "robust", a best interests decision could still be sought from court.

Treatment will not be withdrawn for existing patients until the review group's view is known or further consideration by the court.

The same interim process will be used for new patients once the Tavistock clinic decides to resume making new referrals, NHS England said.

A statement from Tavistock and Portman said it welcomed the update "that parental consent may form a legal basis to prescribe puberty blockers to children under 16 years".

The trust added: "We will be working with NHS England on the implications of these changes for patients currently in treatment and new referrals, and will issue more information about this as soon as we are able."

New referrals were paused in December following the High Court ruling.

The review group will be made up of health and care professionals with expertise in child development, neurodevelopment and mental health.

It's not clear when it will be established but NHS England said more details would be available "in due course".

Until the group is operational a requirement for a best interests order from the court, for new patients, will remain.

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